Peritonite esclerosante encapsulante pós-diálise peritoneal

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Date
2013-03-01Author
Cestari, Alexandre Tagliari
Conti, Marina Lourenço De [UNIFESP]
Prats, João Antonio Gonçalves Garreta
Sato Junior, Henri
Abensur, Hugo
Type
ArtigoISSN
0101-2800Is part of
Jornal Brasileiro de NefrologiaDOI
10.5935/01012800.20130010Metadata
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Sclerosing encapsulating peritonitis after peritoneal dialysisAbstract
Patients with chronic renal failure in use of peritoneal dialysis (PD) are subject to various complications of the renal replacement therapy. We report a rare complication of PD in which the peritoneum, after years of contact with hypertonic dialysate, is gradually replaced by fibrous tissue. This patient had several complications after initiation of PD including a bacterial peritonitis, tertiary hyperparathyroidism (being treated with parathyroidectomy 2) and cholelithiasis (being treated with laparoscopic cholecystectomy). After 8 years of peritoneal dialysis was transferred to hemodialysis by decreasing ultrafiltration and episodes of intestinal sub-occlusion, being diagnosed as sclerosing encapsulating peritonitis (SEP). He is currently on corticotherapy with a significant reduction of symptoms and likely stabilization of the SEP. Pacientes com insuficiência renal crônica terminal em uso de diálise peritoneal (DP) estão sujeitos a diversas complicações da própria terapia de substituição renal. Relatamos uma complicação rara da DP na qual o peritôneo, após anos de contato com a substância hipertônica dialisante, é gradualmente substituído por tecido fibroso. O paciente em questão teve diversas intercorrências após o início da DP, incluindo uma peritonite bacteriana, hiperparatireoidismo terciário (sendo tratado com duas paratireoidectomias) e colelitíase (sendo tratado com colecistectomia videolaparoscópica). Após 8 anos de diálise peritoneal, foi transferido para hemodiálise por diminuição da ultrafiltração e episódios de suboclusão intestinal, sendo diagnosticado como peritonite esclerosante encapsulante (PEE). Atualmente, está em corticoterapia e com diminuição significativa dos sintomas e provável estabilização da PEE.
Citation
Jornal Brasileiro de Nefrologia. Sociedade Brasileira de Nefrologia, v. 35, n. 1, p. 65-68, 2013.Keywords
case reportsperitoneal dialysis
continuous ambulatory
peritoneal fibrosis
diálise peritoneal
diálise peritoneal ambulatorial contínua
fibrose peritoneal
relatos de casos
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- EPM - Artigos [17708]
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